Multiple factor scoring systems (Ranson’s criteria and APPACHE II classification system) and individual laboratory tests of pancreatitis

injury and inflammatory response were compared using ANOVA one way test of variances for the degree of pancreatic damage. P value < 0.001 was considered statistically significant. Results: Fourty- six patients (67.6%) were males MK-8669 and twenty two (32.4%) females. AP was associated with gallstone disease in 33 patients (48.5%), due to alcohol abuse in 29 (42.6%), and due to other causes of unknown origin in 6 (8.9%). M ± SD value of age, white cells and the number of positive Ranson and APACHE II variables were significantly higher in patients included in the group III compared with those of Buparlisib cell line group I, 58.89 ± 16.93 years vs 42.21 ± 16.55 years (p < 0.001), 17800 ± 7000 vs 11143 ± 5692 (p < 0.001), 3.63 ± 1.26 vs 1.79 ± 1.25 (p < 0.001) and 14.47 ± 4.3 vs 8.07 ± 1.14 (p < 0.001), respectively. There were futhermore significant differences in Ranson's criteria and APACHE II classification system between the patients of the group II and III. Although without significant difference, M ± SD of hematocrit and fasting blood sugar were higher in the patients of the group III compared to those of the group I, 35.12 ± 10.71 vs 32.69 ± 14.65 and 157.82 ± 48.42 vs 153.90 ± 108.90, respectively. Conclusion: The early detection of pancreatic necrosis signifies severe disease and is being

used as a grave prognostic indicator in the initial evaluation of these patients. Balthazar grade score plus necrosis score in combination with age, white blood cells and multiple factor score systems may be largely used to asses the severity of AP. Key Word(s): 1. 上海皓元医药股份有限公司 AP; 2. Balthazar score; 3. pancreatic necrosis; 4. severity; Presenting Author: XUE LIU Corresponding Author: XUE LIU Affiliations: Ganzhou City People’s Hospital Objective: To analysis clinical feature of the different etiology of acute pancreatitis (AP), offer information about prevention and

cure of acute pancreatitis. Methods: The clinical data of 82 patients with AP admitted to our hospital from January 2011 to January 2013 were reviewed and were divided into 4 groups according to etiology, analysise the difference from gender, age, clinical symptoms, tiology of pathogenesis of acute pancreatitis. Results: The constituent ratio of etiology of acute pancreatitis the 4 groups were was biliary tract diease (67.1%), alcoholic pancreatitis (6.1%), hyperlipidemic acute pancreatitis (4.9%), and others reason (21.9%). The average age of four group was no significant difference (P > 0.05), The number of female were significantly less in the alcoholic pancreatitis group (P < 0.01). The cause of Mild Acute Pancreatitis and Sereve Acute Pancreatitis was no significant difference. All the acute pancreatitis patients had belly ache. The blood calcium and the blood albumin of the four groups were no significant difference (P > 0.05).

The pooled eradication rate was 66.4% (99/149) by Hydroxychloroquine ic50 ITT in experiment group and 67.4% (85/126) by ITT in control group. The incidences of total adverse effects were 21.7% (97/435) in the experimental groups and 26.4% (140/474) in the control groups. The pooled OR was 0.79 (95%CI: 0.34-1.85) by random effect model

(I 2 = 83.4%, P = 0.000). Conclusion: Available data suggest that the effectiveness of regimens with rifabutin, PPIs and amoxicillin for Helicobacter pylori rescue therapy may be not superior to that of control regimens. Key Word(s): 1. Helicobacter pylori; 2. amoxicillin; 3. rifabutin; 4. systemic review; 5. meta-analysis Presenting Author: KIKI MAHARANI Additional Authors: ARITANTRI DARMAYANI, PAULUS KUSNANTO, TRI YULI PRAMANA, M. buy Ceritinib TANTORO HARMONO Corresponding

Author: KIKI MAHARANI Affiliations: Moewardi Hospital, Moewardi Hospital, Moewardi Hospital, Moewardi Hospital Objective: It is generally known that Helicobacter pylori (H. pylori) infection is associated with renal dysfunction. Many reports suggest that chronic H. pylori infections may be associated with atherosclerosis and inflammations. Atherosclerosis and inflammation will decrease renal function. The aim of this study was to investigate the association between Helicobacter pylori infection and creatinin clearance in patient with dyspepsia. Methods: This retrospective study was conducted between Januari 2014 until Juni 2014 in Moewardi Hospital Surakarta. Inclusion criteria

was dyspepsia syndrome. Exclusion criteria was chronic kidney disease, chronic liver disease, malignancy, infection and diabetes mellitus. Glomerular filtration rate (eGFR) were estimated by Cockroft-Gault formula. H pylori infection identified by positive biopsi specimen from endoscopy. Statistical analysis using independence t-test and Pearson correlation test with SPSS 20, significant if p < 0,05. Results: There were 121 patient, 53 man and 68 woman with 34 positive H . pylori and 87 negative H pylori . The mean creatinin was 1,50 + 2,01 mg/dL, mean ureum 53,88 + 52,98 mg/dL, and mean eGFR 90,32 + 104,37 mL/min/1.73 m2 . There was negative correlation between h pilory infection 上海皓元 and eGFR in patient with syndrom dyspepsia (p:0,002, r:-0, 378). Key Word(s): 1. Helicobacter pylori; 2. dyspepsia syndrom; 3. estimated glomerolus filtration rate Presenting Author: HIROKI SHIMODA MEN Additional Authors: HIROKI SHIMODA, RIKA NAKANO Corresponding Author: HIROKI SHIMODA Affiliations: Jcho Takanawa Hospital, Jcho Takanawa Hospital Objective: Introduction : In Japan, due to the improved sanitation and hygiene, the prevalence of Helicobacter pylori infection has been decreasing among young people, but its prevalence is still high among middle-aged or elderly people. And more and more people are diagnosed with diabetes in today’s Japan.

The pooled eradication rate was 66.4% (99/149) by HSP inhibitor cancer ITT in experiment group and 67.4% (85/126) by ITT in control group. The incidences of total adverse effects were 21.7% (97/435) in the experimental groups and 26.4% (140/474) in the control groups. The pooled OR was 0.79 (95%CI: 0.34-1.85) by random effect model

(I 2 = 83.4%, P = 0.000). Conclusion: Available data suggest that the effectiveness of regimens with rifabutin, PPIs and amoxicillin for Helicobacter pylori rescue therapy may be not superior to that of control regimens. Key Word(s): 1. Helicobacter pylori; 2. amoxicillin; 3. rifabutin; 4. systemic review; 5. meta-analysis Presenting Author: KIKI MAHARANI Additional Authors: ARITANTRI DARMAYANI, PAULUS KUSNANTO, TRI YULI PRAMANA, M. see more TANTORO HARMONO Corresponding

Author: KIKI MAHARANI Affiliations: Moewardi Hospital, Moewardi Hospital, Moewardi Hospital, Moewardi Hospital Objective: It is generally known that Helicobacter pylori (H. pylori) infection is associated with renal dysfunction. Many reports suggest that chronic H. pylori infections may be associated with atherosclerosis and inflammations. Atherosclerosis and inflammation will decrease renal function. The aim of this study was to investigate the association between Helicobacter pylori infection and creatinin clearance in patient with dyspepsia. Methods: This retrospective study was conducted between Januari 2014 until Juni 2014 in Moewardi Hospital Surakarta. Inclusion criteria

was dyspepsia syndrome. Exclusion criteria was chronic kidney disease, chronic liver disease, malignancy, infection and diabetes mellitus. Glomerular filtration rate (eGFR) were estimated by Cockroft-Gault formula. H pylori infection identified by positive biopsi specimen from endoscopy. Statistical analysis using independence t-test and Pearson correlation test with SPSS 20, significant if p < 0,05. Results: There were 121 patient, 53 man and 68 woman with 34 positive H . pylori and 87 negative H pylori . The mean creatinin was 1,50 + 2,01 mg/dL, mean ureum 53,88 + 52,98 mg/dL, and mean eGFR 90,32 + 104,37 mL/min/1.73 m2 . There was negative correlation between h pilory infection MCE公司 and eGFR in patient with syndrom dyspepsia (p:0,002, r:-0, 378). Key Word(s): 1. Helicobacter pylori; 2. dyspepsia syndrom; 3. estimated glomerolus filtration rate Presenting Author: HIROKI SHIMODA MEN Additional Authors: HIROKI SHIMODA, RIKA NAKANO Corresponding Author: HIROKI SHIMODA Affiliations: Jcho Takanawa Hospital, Jcho Takanawa Hospital Objective: Introduction : In Japan, due to the improved sanitation and hygiene, the prevalence of Helicobacter pylori infection has been decreasing among young people, but its prevalence is still high among middle-aged or elderly people. And more and more people are diagnosed with diabetes in today’s Japan.

A number of studies to help address these evidence gaps are suggested: however, it is also recommended that analysts continue to adhere to established conventions when conducting and reporting economic evaluations. “
“Summary.  Boys with haemophilia are now encouraged to exercise and take part in physical activities, but actual measures of time spent in active participation is lacking. The aim of this study was to obtain an objective

measure of daily physical activity in boys with haemophilia as compared with healthy controls. The study also aimed to ascertain the selleck products social and cognitive factors associated with exercise in this population. Seventeen patients (aged 11–18 years) with haemophilia were studied and compared with 44 healthy controls (aged 10–16.5 years). Physical activity was measured by accelerometry. Psychosocial correlates were assessed using validated questionnaires. Measured physical activity levels in subjects with haemophilia were slightly higher than for the control group. Both groups spent 70% of the day inactive, with similar proportions RAD001 of time in moderate and vigorous activity. Subjects with haemophilia had a favourable self-image and similar levels of anxiety as peers without a bleeding disorder. Self-efficacy scores were lower than for controls suggesting increased

sensitivity to barriers and lack of acceptance of alternatives. Health beliefs did not influence physical activity, but a negative correlation of time spent in high or vigorous activity with scores for support-seeking was observed. The data demonstrate that in the appropriate social environment and with medical support, patients with haemophilia may be as physically active as their peers without a bleeding disorder. Further investigation into the psychosocial barriers of physical

activity in patients with haemophilia MCE公司 is needed to more effectively encourage healthy behaviours. “
“Development of alloantibodies against infused factor VIII (FVIII) is the most significant complication of haemophilia care today. Antibodies inactivate the procoagulant activity of FVIII and inhibit patients’ response to replacement therapy. As inhibitors tend to develop early in the course of FVIII treatment, the challenge is to bring patients through the critical early phase of FVIII exposure without inhibitor development as the subsequent risk is much lower. Disease severity, major FVIII gene defects, family history and non-Caucasian race are major risk factors for inhibitor development. Other variables thought to play a role in inhibitor formation include age at first treatment, intensity of early treatment, use of prophylaxis and product choice [especially recombinant vs. plasma-derived von Willebrand factor (VWF)-containing concentrates]. As these treatment-related variables are modifiable, they provide opportunity to minimize inhibitor incidence at the clinical level.

Primary antibodies against ErbB2 (C-18; sc-284), phospho-ErbB2 (Tyr1248; sc-12352-R), ErbB1 (1005; sc-03), and phospho-ErbB1 (Tyr1173; sc-12351)

were purchased from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA). Primary antibodies against phospho-Akt (Ser 473; #9271), Akt (#9272), phospho-p42/44 mitogen-activated protein kinase (MAPK) (Thr202/Thr204; #4377), p42/44 MAPK (#9102), caspase-3 (#9662), and cyclin D1 (#2926) were purchased from Cell Signaling Technology (Beverly, MA). Anti-actin (A 2066) was obtained from Sigma Aldrich Co. Vismodegib research buy (St. Louis, MO). Tryphostin AG879 and tryphostin AG1517 were purchased from Calbiochem-Novabiochem Corp. (San Diego, CA). Lapatinib was kindly provided by GlaxoSmithKline, Inc. (Research Triangle Park, NC). The rat cholangiocarcinoma cell lines C611B and BDEneu were each generated in our laboratory and have been previously described.3-5 The human cholangiocarcinoma cell line, HuCCT1, was purchased from ICG-001 the Japan Health Science Foundation (Osaka, Japan). TFK1, the other human cholangiocarcinoma cell line used in this study, was purchased from the German Collection of Microorganisms and

Cell Cultures (Braunschweig, Germany). All of the cholangiocarcinoma cell lines used in this study, with the exception of the HuCCT1 cell line, were cultured in Dulbecco’s modified Eagle medium (DMEM) supplemented according to our standard culture conditions.3 HuCCT1 cells were cultured under comparable conditions in Roswell Park Memorial Institute 1640 (RPMI-1640) medium. In vitro drug treatments with tryphostins AG879 and AG1517, alone and in combination, as well as with lapatinib,

were carried out against the various rat and human cholangiocarcinoma cell lines maintained in culture in either DMEM or RPMI-1640 medium in the presence of 2.5% fetal bovine serum. A range of concentrations of each TK 上海皓元 dissolved in dimethyl sulfoxide (DMSO; final DMSO concentration per culture = 0.1%) were added to the culture medium of the drug-treated cultures, beginning at 16-24 hours after initial cell plating and then continuing daily for up to an additional 72 hours, depending on the experimental design. Vehicle control cultures were exposed to 0.1% DMSO only. In vitro cell growth was assessed using the CellTiter 96 Aqueous Non-Radioactive Cell Proliferation Assay Kit from Promega Corp. (Madison, WI), as described.4, 6 Western blot analysis of total protein in cell lysates prepared from vehicle control and ErbB TK inhibitor–treated cholangiocarcinoma cell lines was also performed as described,4, 7 using commercially available antibodies that had been validated by us for reactivity and specificity.

These patients should be referred to Hepatology units working with a liver transplantation programme. Factors which are associated with a reduced chance of achieving SVR include a high pretreatment HCV viral titre, failure to achieve RVR or http://www.selleckchem.com/products/BIBW2992.html EVR, genotype 1 infection, presence of cirrhosis, older age at the time of infection and African racial origin. A genetic polymorphism near the IL28B gene encoding for interferon-λ-3 has been identified as being associated with a twofold difference in response to PegIFN/ribavirin treatment [12]. Testing for the IL28B polymorphism can now be performed in most hepatology reference

centres and can provide useful information to decide which treatment regimen to start. HCV RNA should be assessed in all HIV-positive persons, as approximately 6% of these individuals fail to develop detectable HCV antibodies so a negative antibody test result should not be interpreted as indicating that the patient does not have HCV infection. The management of these patients has been reviewed recently in the UKHCDO guidelines

[10]. Patients coinfected with HIV and HCV have an approximately twofold greater risk of developing cirrhosis, and progress more rapidly to liver failure compared with HCV anti-CTLA-4 antibody monoinfected individuals. The importance of the need to treat HCV in this patient group should therefore be emphasized. To optimize

response to anti-HCV treatment, HIV infection should be fully suppressed using HAART. HAART regimens should not include zidovudine (AZT) as this is contraindicated with ribavirin because of the potential for severe anaemia. Didanosine and stavudine should also be avoided because of the interaction with ribavirin and the risk of potentially fatal lactic acidosis. The impact of abacavir on treatment responses to HCV combination therapy is currently debated. HIV non-progressors who are maintaining normal CD4 counts, not on HAART should also be encouraged to undertake HCV treatment. Co-infected patients have lower SVRs with PegIFN/ribavirin treatment compared with 上海皓元医药股份有限公司 monoinfected individuals. In the meta-analysis reported by Franchini, coinfected patients had an overall SVR of 29% [9]. Clinical trials of protease inhibitor based triple therapy are currently ongoing in HIV/HCV coinfected patients to assess, safety and efficacy, as well as drug–drug interactions which can be problematic in this patient population. The first direct acting antivirals belonging to the class of protease inhibitors (boceprevir, telaprevir) have been recently approved, but are restricted to the treatment of HCV genotype 1 infections [13].

These patients should be referred to Hepatology units working with a liver transplantation programme. Factors which are associated with a reduced chance of achieving SVR include a high pretreatment HCV viral titre, failure to achieve RVR or see more EVR, genotype 1 infection, presence of cirrhosis, older age at the time of infection and African racial origin. A genetic polymorphism near the IL28B gene encoding for interferon-λ-3 has been identified as being associated with a twofold difference in response to PegIFN/ribavirin treatment [12]. Testing for the IL28B polymorphism can now be performed in most hepatology reference

centres and can provide useful information to decide which treatment regimen to start. HCV RNA should be assessed in all HIV-positive persons, as approximately 6% of these individuals fail to develop detectable HCV antibodies so a negative antibody test result should not be interpreted as indicating that the patient does not have HCV infection. The management of these patients has been reviewed recently in the UKHCDO guidelines

[10]. Patients coinfected with HIV and HCV have an approximately twofold greater risk of developing cirrhosis, and progress more rapidly to liver failure compared with HCV BGJ398 datasheet monoinfected individuals. The importance of the need to treat HCV in this patient group should therefore be emphasized. To optimize

response to anti-HCV treatment, HIV infection should be fully suppressed using HAART. HAART regimens should not include zidovudine (AZT) as this is contraindicated with ribavirin because of the potential for severe anaemia. Didanosine and stavudine should also be avoided because of the interaction with ribavirin and the risk of potentially fatal lactic acidosis. The impact of abacavir on treatment responses to HCV combination therapy is currently debated. HIV non-progressors who are maintaining normal CD4 counts, not on HAART should also be encouraged to undertake HCV treatment. Co-infected patients have lower SVRs with PegIFN/ribavirin treatment compared with MCE公司 monoinfected individuals. In the meta-analysis reported by Franchini, coinfected patients had an overall SVR of 29% [9]. Clinical trials of protease inhibitor based triple therapy are currently ongoing in HIV/HCV coinfected patients to assess, safety and efficacy, as well as drug–drug interactions which can be problematic in this patient population. The first direct acting antivirals belonging to the class of protease inhibitors (boceprevir, telaprevir) have been recently approved, but are restricted to the treatment of HCV genotype 1 infections [13].

Results:  The mean SBI of the simple steatosis group was 15.8 ± 3.9, while that of the NASH with mild fibrosis group was 18.7 ± 5.7. This difference between the two groups was significant (P = 0.0314). A multiple

logistic regression analysis showed that the SBI was significantly correlated with the discrimination of simple steatosis and NASH with mild fibrosis. The area under this website the receiver–operator curve was 0.661 for distinguishing between simple steatosis and NASH with mild fibrosis (P = 0.026, 95% confidence interval = 0.532–0.789). Conclusion:  Spleen enlargement may be a distinct feature of NASH, especially early-stage NASH. SBI might be a non-invasive and simple method of differentiating NASH and simple steatosis. find more “
“Aim:  There is no clear consensus on the optimal timing of surgical resection for synchronous colorectal liver metastases (SCLM). This study is a meta-analysis of the available evidence. Methods:  Systematic review and

meta-analysis of trials comparing outcomes following simultaneous resection with staged resection for SCLM published from 1990 to 2010 in PubMed, Embase, Ovid and Medline. Pooled odds ratios (OR) or weighted mean differences (WMD) with 95% confidence intervals (95% CI) were calculated using either the fixed effects or random effects model. Results:  Nineteen non-randomized controlled trials (NRCT) studies were included in this analysis. These studies included a total of 2724 patients: 1116 underwent simultaneous resection and 1608 underwent staged resection. Meta-analysis showed that shorter hospital stay (P < 0.001) and lower total complication rate (P < 0.001) were observed in patients undergoing simultaneous resection group. The overall survival rate in the simultaneous resection group did not statistically differ with that in the staged resection group at 1 year (P = 0.13), 3 years (P = 0.26), 5 years (P = 0.38), as well as the 1, 3 and 5 years disease-free survival rates (respectively, P = 0.55; P = 0.16; P = 0.12). No significant difference was noted between the two groups in terms of mortality (P = 0.16), intraoperative blood loss (P = 0.06) and recurrence (P = 0.47).

Conclusion:  Simultaneous resection is safe and efficient in the treatment of patients with SCLM while avoiding a second laparotomy. In selected patients, simultaneous 上海皓元医药股份有限公司 resection might be considered as the preferred approach. However, the findings have to be carefully interpreted due to the lower level of evidence and the existence of heterogeneity. COLORECTAL CANCER REMAINS one of the most common malignancies worldwide; in western countries, it is the second most common cause of cancer-related death.1 More than 50% of patients with colorectal cancer (CRC) might have liver metastases during the course of their disease.2 In 20% of patients with colorectal liver metastases (CLM), the liver is the only site of metastatic disease.

Results:  The mean SBI of the simple steatosis group was 15.8 ± 3.9, while that of the NASH with mild fibrosis group was 18.7 ± 5.7. This difference between the two groups was significant (P = 0.0314). A multiple

logistic regression analysis showed that the SBI was significantly correlated with the discrimination of simple steatosis and NASH with mild fibrosis. The area under CCI-779 in vivo the receiver–operator curve was 0.661 for distinguishing between simple steatosis and NASH with mild fibrosis (P = 0.026, 95% confidence interval = 0.532–0.789). Conclusion:  Spleen enlargement may be a distinct feature of NASH, especially early-stage NASH. SBI might be a non-invasive and simple method of differentiating NASH and simple steatosis. Inhibitor Library molecular weight “
“Aim:  There is no clear consensus on the optimal timing of surgical resection for synchronous colorectal liver metastases (SCLM). This study is a meta-analysis of the available evidence. Methods:  Systematic review and

meta-analysis of trials comparing outcomes following simultaneous resection with staged resection for SCLM published from 1990 to 2010 in PubMed, Embase, Ovid and Medline. Pooled odds ratios (OR) or weighted mean differences (WMD) with 95% confidence intervals (95% CI) were calculated using either the fixed effects or random effects model. Results:  Nineteen non-randomized controlled trials (NRCT) studies were included in this analysis. These studies included a total of 2724 patients: 1116 underwent simultaneous resection and 1608 underwent staged resection. Meta-analysis showed that shorter hospital stay (P < 0.001) and lower total complication rate (P < 0.001) were observed in patients undergoing simultaneous resection group. The overall survival rate in the simultaneous resection group did not statistically differ with that in the staged resection group at 1 year (P = 0.13), 3 years (P = 0.26), 5 years (P = 0.38), as well as the 1, 3 and 5 years disease-free survival rates (respectively, P = 0.55; P = 0.16; P = 0.12). No significant difference was noted between the two groups in terms of mortality (P = 0.16), intraoperative blood loss (P = 0.06) and recurrence (P = 0.47).

Conclusion:  Simultaneous resection is safe and efficient in the treatment of patients with SCLM while avoiding a second laparotomy. In selected patients, simultaneous 上海皓元 resection might be considered as the preferred approach. However, the findings have to be carefully interpreted due to the lower level of evidence and the existence of heterogeneity. COLORECTAL CANCER REMAINS one of the most common malignancies worldwide; in western countries, it is the second most common cause of cancer-related death.1 More than 50% of patients with colorectal cancer (CRC) might have liver metastases during the course of their disease.2 In 20% of patients with colorectal liver metastases (CLM), the liver is the only site of metastatic disease.

2B, Supporting Fig. 1). Again, the segregation between progressors and nonprogressors is evident. We then tested 250 proteins, 154 up-regulated and 96 down-regulated, that define the clusters shown in Fig. 2, for confounding factors. HM781-36B The signature is robust against time (Fig. 2B), and all the potential confounding clinical factors are listed in Supporting

Fig. 3. The calculation of external isolation (a measure for how well individual biologic conditions separate) and internal cohesiveness (a measure for how well members of a single biological condition cluster together), and indicated in the different panels, allow quantification of this statement when compared with Fig. 2A and 2B. In conclusion, the subset of statistically significant differentially abundant proteins may indicate whether a patient will progress to severe liver disease posttransplantation. Consistent with the literature, we observed a significantly greater mean donor age in patients with rapidly progressive fibrosis (Table 1). The biological significance of the altered protein abundance pattern described above was further investigated by classifying the associated proteins within the context of biologically relevant functions using IPA. Patients with rapid fibrosis progression exhibited an enrichment of down-regulated proteins mapping to signaling or disease

pathways associated with hepatoprotective Linsitinib molecular weight activities, whereas up-regulated proteins

mapped to various immune response pathways (Table 2 and Supporting Table 6). With regard to the MCE latter, the representation of allograft rejection signaling pathways reflects the functional redundancy of proteins associated with inflammatory conditions attributed to viral recurrence or graft rejection, processes that are difficult to discern because they are histologically indistinguishable. We note that all patients received different combinations of immune-suppressing drugs, including treatment for graft rejection that trended with rapid fibrosis progression at 1 year posttransplantation (Table 1). However, we did detect differential regulation of biological processes such as proinflammatory innate immune activities and positive regulation of interferon gamma protein expression and downstream targets consistent with those described during the transcriptional deregulation associated specifically with HCV recurrence, rather than acute cellular rejection.23 Not surprisingly, patients with progressive liver disease further exhibited an enrichment of differentially regulated proteins mapping to the IPA toxicologic functional category of liver fibrosis, including proteins associated with hepatic stellate cell activation (P < 0.05), and demonstrate the possibility of detecting protein abundance profiles consistent with hepatic damage weeks or months prior to clinical evidence of liver injury.